Individual provider Active NPI

Meg Wagner Rodney, P.T.

  • Pediatric Physical Therapist
  • Yuma, AZ
National Provider Identifier
1558532192
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
5016 Issued in AZ
Practice address
11426 E del Golfo
Yuma, AZ 85367-8952
Phone
(928) 210-2413
Fax
(928) 819-7019
NPI assigned
Mar 21, 2008
Last updated
Oct 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 5016 AZ Primary

Addresses

Primary practice location

11426 E del Golfo
Yuma, AZ 85367-8952

Mailing address

PO Box 25385
Yuma, AZ 85367-1317
Phone (928) 210-2413

Other identifiers 1

IdentifierTypeStateIssuer
465113MedicaidAZ

Other names 1

  • Meg Ellen Wagner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5016AZMDOrthopaedic Surgery Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1558532192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25385",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853671317",
            "telephone_number": "928-210-2413",
            "fax_number": "928-819-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11426 E DEL GOLFO",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853678952",
            "telephone_number": "928-210-2413",
            "fax_number": "928-819-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODNEY",
        "first_name": "MEG",
        "middle_name": "WAGNER",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "5016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465113",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEG",
            "last_name": "WAGNER",
            "middle_name": "ELLEN",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.